OBJECTIVES: To evaluate the clinical, epidemiological and therapeutic aspects of patients with diabetic macular edema (DME) and the economic aspects of anti-VEGF made available by court order.

METHODS: A retrospective, descriptive and analytical study developed at NAT-Jus/TJMS and in the ophthalmology sector of Hospital São Julião (HSJ), where data was collected from the medical records of a cohort of patients with EMD who received injections of anti- VEGF by court order.

RESULTS: The majority of female patients (53.8%), with low education level (61.4% elementary school), white (51.0%) and married (52.4%) were identified. Cataract was the prevalent comorbidity (71.0%), followed by arterial hypertension (44.1%). Eight hundred and fifty three injections of anti-VEGF were performed in 240 eyes, corresponding to 145 patients. Adherence to treatment was 31.0%, while adverse eye reactions were 6.2%. The evolution of visual acuity occurred with an average gain of 3.8 letters (ETDRS). The average number of injections was 4.4 in 12 months, 3.5 in 24 months and 36 months, three in 48 months and four in 60 months.

CONCLUSIONS: The advanced condition of the disease suggests the need for early detection through screening programs. We observed a smaller number of anti-VEGF applications compared to what is recommended in the package insert. Rates of adherence to treatment, improvement in visual acuity and regression of edema were lower than that observed in other studies. The judicialization of anti-VEGF drugs for the treatment of retinopathies induced the Government to sign an agreement with a philanthropic institution in order to serve these patients, promoting benefits to the entire population. The low adherence of patients indicates the need for criteria for continuing to comply with the judicial sentence in order to induce the patient to follow all medical recommendations for treatment.